This inspection took place on 9 August 2018 and was unannounced. The last inspection for the service was 27 February 2017 and this was a focused inspection. This was in regard to a recommendation made from 25 July 2016 comprehensive inspection in relation to safe care and treatment. The service was rated overall as Good.

St Anne’s Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

St Anne's Home provides accommodation for 34 people who require nursing or personal care. At the time of our inspection there were 32 people living at the home. Accommodation was provided over three floors and offered comfortable and spacious facilities. There were a number of independent flats attached to the home including separate living quarters for the Sisters. The aim of the provider is to offer the highest quality of care and security for older people, taking into account the particular conditions associated with the ageing process.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People did not always receive time specific medicines at the correct time, which may have affected their health and well-being. The arrangements for storing medicines for people were not always robust. Medicines records were not always completed fully and accurately. We were not assured that appropriate arrangements were in place for the recording, using and safe administration of some medicines.

Staff told us they felt supported and received supervision and training. However, the home did not record formal supervision for all staff that worked at the service. Staff received appraisals twice yearly. The home had recruitment procedures in place however the provider did not have a system in place to update criminal record checks for staff.

The home did not follow their complaints policy whilst addressing people’s complaints. The home did not have an effective system in place to record and investigate complaints.

The home had monitoring and auditing systems in place to check the safety and quality of the service. However, they were not always effective in identifying gaps and errors. People, relatives staff, and health and social care professionals told us the senior management was approachable. People’s, relatives’ and health and social care professionals feedback was sought and considered to improve the service.

The service had appropriate systems in place for safeguarding people. Risk assessments were in place which provided guidance on how to support people safely. There were enough staff to meet people’s needs.

People were able to make choices about most aspects of their daily lives. People were provided with a choice of food and drink and supported to eat healthily. People had access to health care professionals and were supported to lead healthy lifestyles.

People and their relatives told us they liked the staff. We saw staff interacting with people in a caring way and staff had a good understanding of how to promote people’s dignity.

Care plans were in place and people were involved in planning the care and support they received. People had access to a wide variety of activities at the home.

We have made two recommendations about formal supervision for staff and continued suitability for staff to work with vulnerable people or people at risk.

We found the registered provider was not meeting legal requirements and was in breach of three Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was in relation to saf

We carried out an unannounced comprehensive inspection of this service on 25 July 2016 and made one recommendation relating to safe care and treatment. After the comprehensive inspection, the provider wrote to us to say what they would do to meet the requirement in relation safe care and treatment. We undertook this focused inspection on 27 February 2017 to check that they had followed up on our recommendation.

This report only covers our findings in relation to this recommendation. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘St Anne’s Home London’ on our website at www.cqc.org.uk’.

St Anne's Home provides accommodation for 32 people who require nursing or personal care. The home is situated in the town of Stoke Newington and close to community facilities. At the time of our inspection there were 32 people living at the home.

Accommodation was provided over three floors and offered comfortable and spacious facilities. There were a number of independent flats attached to the home including separate living quarters for the Sisters. The aim of the provider is to offer the highest quality of care and security for older people, taking into account the particular conditions associated with the ageing process.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People in the home told us they felt safe. Staff followed environmental risk management plans and further training had taken place. Improvements had been made to the environment to mitigate identified risks and people had been informed of these changes.

We inspected St Anne’s Home on 25 July 2016, the inspection was unannounced. Our last inspection took place on 29 July 2013 and we found that the provider was meeting all of the regulations that we checked.

St Anne’s Home provides accommodation for 32 people who require nursing or personal care. The home is situated in the town of Stoke Newington and close to community facilities. At the time of our inspection there were 30 people living at the home.

Accommodation was provided over three floors and offered comfortable and spacious facilities. There was a number of independent flats attached to the home including separate living quarters for the Sisters. The aim of the provider is to offer the highest quality of care and security for older people, taking into account the particular conditions associated with the ageing process.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Staff had a clear understanding of safeguarding and whistleblowing procedures and had received training on how to protect people from harm.

Risk assessments had not always been followed in relation to the environment to ensure that they were always protected from avoidable harm. People’s healthcare needs were assessed to show how risks should be minimised and staff adhered to the guidelines.

The provider had the appropriate systems in place to ensure medicines were managed safely. Staff had received the required mandatory medicines training.

People’s nutritional needs were met and any dietary needs were managed appropriately. Special requests by people were included in the menus.

Good systems were in place to assess the suitability of the staff employed. Sufficient numbers of staff were available to meet people's needs in a timely way. Staff shared their knowledge and information on specific areas of training.

People were involved in decisions about the care they received and told us staff were kind and caring. People’s needs were assessed before they moved to the home.

Staff worked within the principles of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards.

People had access to a wide range of activities that were both individualised as well as meaningful for people. People’s religious, cultural and social needs were met and their wishes were respected and valued.

Reasonable adjustments were in place to support people with their healthcare needs. People were supported to maintain good health and to obtain treatment when required. Healthcare professionals spoke positively about the service.

Spacious well-equipped facilities were available to people and their privacy and dignity was respected. There was an effective transitional process in place for people when they were referred into the home.

Staff were well supported by the registered manager and enjoyed their work together as a team.

People’s views were sought on how the home was managed. Complaints had been responded to appropriately when they were raised.

The registered manager and provider had quality monitoring systems in place, which helped ensure that all areas of the service were working well. However, these were not always effective as they had failed to identify that staff were not always following an environmental risk management plan.

We have made one recommendation relating to safe care and treatment.

People we spoke with were happy with the service. One person said, "it is lovely here. We are all very happy." One relative said, "staff are wonderful. They provide 100 per cent care." People who used the service received assistance with personal care and support with their daily living activities. Their needs were assessed and care and treatment was planned and delivered in line with their individual care plan. Medicines were handled safey and appropriately.

The service had developed links with local NHS professionals to support people with their health needs. We saw evidence of timely communication with community health services. People who used the service and their relatives spoke positively about staff. One said, "they always come if you need them." Another said, "they are very caring."

Staff received appropriate professional development. They said they were well supported in their roles with access to support when they needed, training and individual supervision.

People who used the service were asked for their views about their care and treatment and we saw evidence this had influenced the delivery of care. Senior staff monitored the quality of the service in a range of ways.

This inspection was part of a themed inspection programme to assess whether older

people living in care homes were treated with dignity and respect and whether their

nutritional needs were met. The inspection team was led by a Care Quality Commission

(CQC) inspector joined by a practising health care professional. We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

We spoke with people who lived in the home and with their relatives. All the people who spoke with us were highly complimentary about the care they received and told us the home was lovely. Their comments included,“the care is magnificent." And, "people’s choices are respected. They try to encourage independence and they are very patient.” One person told us, "staff are lovely. You couldn't better this. It is a very happy place and the care is excellent. I waited a year to get in here."